Provider Demographics
NPI:1093915407
Name:RAHMANI, BIJAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BIJAN
Middle Name:
Last Name:RAHMANI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16756 CHINO CORONA RD
Mailing Address - Street 2:# 6000
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9508
Mailing Address - Country:US
Mailing Address - Phone:909-597-1771
Mailing Address - Fax:909-597-3458
Practice Address - Street 1:16756 CHINO CORONA RD
Practice Address - Street 2:# 6000
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-9508
Practice Address - Country:US
Practice Address - Phone:909-597-1771
Practice Address - Fax:909-597-3458
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12413103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist